Fillable File a Consumer Complaint Against a Business (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

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File a Consumer Complaint Against a Business (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

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New Jersey Ofce of the Attorney General
Division of Consumer Affairs
P.O. Box 45025
Newark, New Jersey 07101
(973) 504-6200
(800)-242-5846
E-Mail: AskConsumerAffairs@dca.lps.state.nj.us
File a Consumer Complaint Against a Business
Few things are more frustrating than paying hard-earned money for a product or service only to discover it
doesn’t measure up to promises or expectations, or that it is just a plain rip-off. When that happens, consumers
rightfully expect to have the problem resolved or their money returned.
Even careful buyers get stuck now and then. If it happens to you, you will want to know how to proceed to get
the best results.
First Contact the Business
Take your problem to the salesperson, manager or the company’s customer service representative. Most
problems are resolved at this level. If you are still not satised, contact the owner or the company’s
headquarters.
If the business will not resolve a problem directly, consumers can le a Consumer Complaint with the Division
of Consumer Affairs, the Better Business Bureau, or a small claims court. The complaint should explain in
detail, with documentation (photocopies), what the problem is, who it is with, what you have done and what you
want. In particular it should:
• Identify the Business
Include the name and current address of the business.
• Describe the Problem
Describe as completely as you can the problem with the product or service you have purchased. Were
you told something that was untrue? Describe what you were told and how it was untrue. Is it
defective? Explain what is wrong. Did the business refuse to honor a warranty? Explain what
needs repair and include a photocopy of the warranty.
• Explain What You Want
Explain what you want the business to do: how much money should be refunded or exactly how you
want a product xed or a service performed.
• Include Photocopies
Always include photocopies of documents relevant to your complaint receipts, warranties, both sides
of cancelled checks, contracts, etc. Do not send originals. Only send copies, except upon request of
the agency to which you are making your complaint.
Please be advised that any information you supply may be subject to public disclosure pursuant to New
Jersey’s Open Public Records Act. If an investigation into the matter is conducted, the information is subject to
public disclosure only after the completion of the investigation. We strongly urge you to not submit sensitive
personal information on these forms.
New Jersey Ofce of the Attorney General
Division of Consumer Affairs
P.O. Box 45025
Newark, New Jersey 07101
(973) 504-6200
(800) 242-5846
E-Mail: AskConsumerAffairs@dca.lps.state.nj.us
Please be advised that any information you supply on this complaint form may be subject to public disclosure. If an
investigation into the matter is conducted, the information is subject to public disclosure only after the investigation is
closed. You are also advised that the completed complaint form is a “government record,” subject to disclosure under the
Open Public Records Act (OPRA).
Complaint RepoRted by: Complaint RepoRted against:
Name:_________________________________________ BusiNess: ______________________________________
address:_______________________________________ address:_______________________________________
City:__________________________________________ City:__________________________________________
state:_______________________ ZiPCode: _________ state:_______________________ ZiPCode: _________
HometelePHoNeNumBer:_________________________ telePHoNeNumBer(1):___________________________
(includeareacode)(includeareacode)
WorktelePHoNeNumBer:_________________________telePHoNeNumBer(2):___________________________
(includeareacode)(includeareacode)
* e-mailaddress:_______________________________
* note: by pRoviding youR e-mail addRess, you agRee to
ReCeive CommuniCations fRom this offiCe by e-mail.
For statistical and informational purposes only. Yourage: 18-29 30-44 45-59 60orolder
1. Natureofcomplaint(pleasechecktheappropriatebox(es)):
Automotive AutomotiveRepairs Banking CreditCard
Charity DirectMail/Sweepstakes HomeRepair Internet/Cyberspace
ProfessionalService Stocks/Securities Telemarketing Telecommunications
Bingo/Rafe HealthClub Warranty Advertising
WheelchairLemonLaw Weighing/MeasuringDevices UsedCarLemonLaw NewCarLemonLaw
Furniture Other(specify)______________________________________________________________
2. Ifyourcomplaintinvolvesamotorvehicle,pleaseprovidethefollowinginformation:
a. New Used
b. Purchased Leased
c. PurchasePrice ___________________ CurrentMileage_________________________
d. DateofPurchase______________________ WithWarranty WithServiceContract AsIs
e. Make___________________________ Model_________________________________ Year _____________
3. Nameofcompanyyoudealtwith:_________________________________________________________________________
____________________________________________________________________________________________________
4. Nameandtitleofcompanyagentsoremployeesyoudealtwith:_________________________________________________
____________________________________________________________________________________________________
5. Describethefactsofyourcomplaintintheorderinwhichtheyhappened.Typeorprintclearly.Useadditionalsheetsofpaper,
ifnecessary.Attach readable copies (no oRiginals) of any complaint-related contracts, bills, receipts, cancelled checks,
correspondence or any other documents you feel are related to your complaint.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
6. Theamountoflossinvolvedinthiscomplaint:$______________ .Pleaseprovideabreakdownoftheselosses:
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Icertifythattheforegoingstatementsmadebymearetrue.Iamawarethatifanyoftheforegoingstatementsmadebymeare
willfullyfalse,Iamsubjecttopunishment.IauthorizetheNewJerseyDivisionofConsumerAffairstosendthiscomplaint
formtothecompanyortointerestedpartiesandtousetheinformationinanywaythatisnecessary.
_______________________________________________________________________________________
Signature*Date
* This certication must be signed by the person completing the form.
9/18/19
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File a Consumer Complaint Against a Business (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

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Completed 21 July 2020

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